Plantar warts are one of several soft tissue conditions of the foot that can be quite painful. Warts are caused by a virus that lives within the deepest layer of the skin, making them difficult to treat. Those that appear on the sole of the foot are called plantar warts. Plantar warts are usually benign. Children, especially teenagers, tend to be more susceptible to warts than adults are. Warts are usually treated conservatively, but can be very stubborn to completely resolve. Plantar warts tend to be hard and flat, with a rough surface and well-defined boundaries; warts that appear on the top of the foot or on the toes are generally raised and fleshier. Sometimes, warts can be confused for corns or rough skin. It is important to note that warts can be very resistant to treatment and have a tendency to re-occur.
Plantar warts are caused by a virus that lives underneath the skin. The plantar wart is often contracted by walking barefoot on dirty surfaces or littered ground where the virus is lurking. The causative virus thrives in warm, moist environments, making infection a common occurrence in communal bathing facilities.
Plantar warts are very difficult to treat without the help of a trained professional. Our office has treatment options available that are not available over-the-counter to the general public. It is wise to visit our office when any suspicious growth or eruption is detected on the skin of the foot in order to ensure a correct diagnosis. It is possible for a variety of more serious lesions to appear on the foot, including malignant lesions such as carcinomas and melanomas. Although rare, these conditions can sometimes be misidentified as warts.
First-line therapy for warts in our office is trimming down the dead skin on top of and surrounding the wart. This is usually painless and allows for medication to penetrate the lesion more effectively. Next, a medication called Cantharone is applied directly to the skin. Cantharone comes from a bug called a blister beetle that kills other insects by spraying a substance that causes blistering. This medication does not hurt upon initial application, but may sting 2-3 days later. After two weeks, the patient returns and the blistered wart is painlessly trimmed away. Sometimes additional treatments may be needed. Our physician has been using this medication with great success.
For more stubborn warts, a simple surgical procedure to excise the wart, performed under local anesthetic, may be indicated. A procedure known as CO2 laser cautery is performed under local anesthesia in an outpatient surgery facility to excise the lesion and cauterize bleeding tissue. The laser reduces post-treatment scarring and is a safe form for eliminating wart lesions. Postoperative care involves daily foot soaks for a week and daily bandaid applications.